| NPI | 1780167890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 041458) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 041458-1) |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2020-03-09 |